Abstract：
BACKGROUND: Primary testicular lymphoma (PTL) is a rare and aggressive malignant tumour with no specific clinical symptoms. Large-scale evidence-based medical evidence to guide preoperative diagnosis is lacking at present. This study aimed to analyse the clinical, pathological and immunohistochemical characteristics of patients with PTL undergoing testicular resection surgery.
METHODS: Literature on the clinical characteristics of patients with PTL undergoing orchiectomy was retrieved from databases, including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang Data. The search covered all available records from the inception of these databases until December 31, 2023. Data extraction was followed by a meta-analysis using Stata 15.0 software.
RESULTS: A total of 22 articles and 475 cases of PTL were included. The meta-analysis revealed that 58.1% of patients with PTL undergoing orchiectomy were under 60 years old, and 41.9% were 60 years or older. The lesion is mostly located on the right side (55.1%). Common symptoms included testicular swelling and falling swelling (91.3%), hydrocele testis (31.0%) and testicular pain (23.0%). Ann Arbor stages I-IV accounted for 53.3%, 16.7%, 14.8% and 15.7%, respectively. Diffuse large B-cell lymphoma (DLBCL) cases were higher at 95.5% than NK/T-cell lymphoma cases at 8.2%. Amongst DLBCL cases, 69.3% were non-germinal centre B-cell (GCB) subtype, and 27.6% were GCB subtype. Immunohistochemistry markers showed 95.9% CD3 negative, 94.9% CD10 negative, 94.4% CD20 positive, 88.4% multiple myeloma oncogene-1 (MUM-1) negative, 73.6% B-cell lymphoma-6 (BCL-6) negative and 66.5% BCL-2 positive. Laboratory findings indicated that 70.4% of patients had a tumour proliferating cell nuclear antigen (Ki67) index of ≥80%, 36.0% had increased serum lactate dehydrogenase level and 22.9% had increased serum β2-microglobulin level.
CONCLUSIONS: PTL is rare, and it often occurs in elderly male patients. Common symptoms include testicular swelling and falling swelling, and the common histological type is DLBCL. Diagnosis should be based on histopathological characteristics and immunohistochemical examination.
METHODS: Literature on the clinical characteristics of patients with PTL undergoing orchiectomy was retrieved from databases, including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang Data. The search covered all available records from the inception of these databases until December 31, 2023. Data extraction was followed by a meta-analysis using Stata 15.0 software.
RESULTS: A total of 22 articles and 475 cases of PTL were included. The meta-analysis revealed that 58.1% of patients with PTL undergoing orchiectomy were under 60 years old, and 41.9% were 60 years or older. The lesion is mostly located on the right side (55.1%). Common symptoms included testicular swelling and falling swelling (91.3%), hydrocele testis (31.0%) and testicular pain (23.0%). Ann Arbor stages I-IV accounted for 53.3%, 16.7%, 14.8% and 15.7%, respectively. Diffuse large B-cell lymphoma (DLBCL) cases were higher at 95.5% than NK/T-cell lymphoma cases at 8.2%. Amongst DLBCL cases, 69.3% were non-germinal centre B-cell (GCB) subtype, and 27.6% were GCB subtype. Immunohistochemistry markers showed 95.9% CD3 negative, 94.9% CD10 negative, 94.4% CD20 positive, 88.4% multiple myeloma oncogene-1 (MUM-1) negative, 73.6% B-cell lymphoma-6 (BCL-6) negative and 66.5% BCL-2 positive. Laboratory findings indicated that 70.4% of patients had a tumour proliferating cell nuclear antigen (Ki67) index of ≥80%, 36.0% had increased serum lactate dehydrogenase level and 22.9% had increased serum β2-microglobulin level.
CONCLUSIONS: PTL is rare, and it often occurs in elderly male patients. Common symptoms include testicular swelling and falling swelling, and the common histological type is DLBCL. Diagnosis should be based on histopathological characteristics and immunohistochemical examination.
摘要：
背景：原发性睾丸淋巴瘤（PTL）是一种罕见且侵袭性的恶性肿瘤，没有特定的临床症状。目前缺乏指导术前诊断的大规模循证医学证据。本研究旨在分析临床，睾丸切除手术PTL患者的病理和免疫组织化学特征。
方法：从数据库中检索有关PTL行睾丸切除术患者临床特征的文献，包括PubMed,WebofScience,Embase,科克伦图书馆,中国国家知识基础设施(CNKI)与万方数据搜索涵盖了从这些数据库开始到2023年12月31日的所有可用记录。数据提取后使用Stata15.0软件进行荟萃分析。
结果：共纳入文献22篇，PTL475例。荟萃分析显示，接受睾丸切除术的PTL患者中有58.1％的年龄在60岁以下，60岁或以上的占41.9%。病变主要位于右侧（55.1%）。常见症状包括睾丸肿胀和跌倒肿胀（91.3%），睾丸鞘膜积液(31.0%)和睾丸疼痛(23.0%)。安阿伯Ⅰ-Ⅳ期占53.3%,16.7%,14.8%和15.7%，分别。弥漫性大B细胞淋巴瘤（DLBCL）病例为95.5％，高于NK/T细胞淋巴瘤病例的8.2％。在DLBCL病例中，69.3％是非生发中心B细胞（GCB）亚型，27.6%为GCB亚型。免疫组化标记显示95.9%CD3阴性,94.9%CD10阴性，94.4%CD20阳性，88.4%多发性骨髓瘤癌基因-1(MUM-1)阴性,73.6%B细胞淋巴瘤-6(BCL-6)阴性和66.5%BCL-2阳性。实验室发现70.4%的患者肿瘤增殖细胞核抗原(Ki67)指数≥80%,36.0％的患者血清乳酸脱氢酶水平升高，22.9％的患者血清β2-微球蛋白水平升高。
结论：PTL很少见，它经常发生在老年男性患者身上。常见的症状包括睾丸肿胀和跌落肿胀，常见的组织学类型为DLBCL。诊断应根据组织病理学特征和免疫组织化学检查。
方法：从数据库中检索有关PTL行睾丸切除术患者临床特征的文献，包括PubMed,WebofScience,Embase,科克伦图书馆,中国国家知识基础设施(CNKI)与万方数据搜索涵盖了从这些数据库开始到2023年12月31日的所有可用记录。数据提取后使用Stata15.0软件进行荟萃分析。
结果：共纳入文献22篇，PTL475例。荟萃分析显示，接受睾丸切除术的PTL患者中有58.1％的年龄在60岁以下，60岁或以上的占41.9%。病变主要位于右侧（55.1%）。常见症状包括睾丸肿胀和跌倒肿胀（91.3%），睾丸鞘膜积液(31.0%)和睾丸疼痛(23.0%)。安阿伯Ⅰ-Ⅳ期占53.3%,16.7%,14.8%和15.7%，分别。弥漫性大B细胞淋巴瘤（DLBCL）病例为95.5％，高于NK/T细胞淋巴瘤病例的8.2％。在DLBCL病例中，69.3％是非生发中心B细胞（GCB）亚型，27.6%为GCB亚型。免疫组化标记显示95.9%CD3阴性,94.9%CD10阴性，94.4%CD20阳性，88.4%多发性骨髓瘤癌基因-1(MUM-1)阴性,73.6%B细胞淋巴瘤-6(BCL-6)阴性和66.5%BCL-2阳性。实验室发现70.4%的患者肿瘤增殖细胞核抗原(Ki67)指数≥80%,36.0％的患者血清乳酸脱氢酶水平升高，22.9％的患者血清β2-微球蛋白水平升高。
结论：PTL很少见，它经常发生在老年男性患者身上。常见的症状包括睾丸肿胀和跌落肿胀，常见的组织学类型为DLBCL。诊断应根据组织病理学特征和免疫组织化学检查。
